Abstract

The post-opioid era represents the climate that exists within pain management services since opioid analgesics are not considered first line treatment for chronic pain. For over a generation, the uses of opioid analgesics were prescribed to a level that contributed to what is now called “the opioid epidemic.” Chronic pain is a major public health problem that affects approximately twenty percent of the American adult population, let alone the excessive financial burden to the tune of approximately $560 billion annually. With this epidemic, the risks about opioid medications were not recognized initially, and in fact notably under-reported. A statistic that represents the excess of opioids in American culture is that although we are five percent of the global population, we use eighty percent of the world’s opioid supply. There is now a generation of patients who have been introduced to opioids and are conditioned to expect pain relief even when the benefits of the medication cease. With the increase in opioid-related deaths over the past decade, clinical and legal guidelines have been developed to define the appropriate use of these agents. Since 2010, there has been a notable reduction in opioid prescribing. Patients who have been maintained on opioids have been deemed as either not appropriate for continued use, weaned from the medications, switched to non-opioid analgesics and confronted with the option of having pain-reducing interventional procedures. Those who have addiction-prone challenges or opioid use disorders are offered other agents to assist in their wean or taper.